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World J Stem Cells. Oct 26, 2020; 12(10): 1050-1066
Published online Oct 26, 2020. doi: 10.4252/wjsc.v12.i10.1050
Inflammatory bowel disease: Therapeutic limitations and prospective of the stem cell therapy
Rangnath Mishra, Punita Dhawan, Anand S Srivastava, Amar B Singh
Rangnath Mishra, Anand S Srivastava, Global Institute of Stem Cell Therapy and Research, San Diego, CA 92122, United States
Punita Dhawan, Amar B Singh, Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, Omaha, NE 68118, United States
Punita Dhawan, Amar B Singh, Fred and Pamela Buffett Cancer Center, Omaha, NE 68118, United States
Punita Dhawan, Amar B Singh, VA Nebraska-Western Iowa Health Care System, Omaha, NE 68118, United States
Author contributions: Mishra R and Singh AB wrote the manuscript; Singh AB, Dhawan P and Srivastava AS conceptualized the idea, reviewed and edited the article.
Supported by Department of Veterans Affairs, No. 2I01BX002761-05 and No. 2I01BX002086-06A1; The National Institutes of Health, No. 1R01DK124095-01A1 and No. 1R21CA216746-01A1.
Conflict-of-interest statement: The authors declare no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Amar B Singh, PhD, Professor, Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, Omaha, NE 68118, United States. amar.singh@unmc.edu
Received: April 29, 2020
Peer-review started: April 29, 2020
First decision: May 24, 2020
Revised: June 2, 2020
Accepted: September 22, 2020
Article in press: September 22, 2020
Published online: October 26, 2020
Processing time: 179 Days and 21.4 Hours
Abstract

Inflammatory bowel disease (IBD), consisting primarily of ulcerative colitis and Crohn’s disease, is a group of debilitating auto-immune disorders, which also increases the risk of colitis-associated cancer. However, due to the chronic nature of the disease and inconsistent treatment outcomes of current anti-IBD drugs (e.g., approximately 30% non-responders to anti-TNFα agents), and related serious side effects, about half of all IBD patients (in millions) turn to alternative treatment options. In this regard, mucosal healing is gaining acceptance as a measure of disease activity in IBD patients as recent studies have correlated the success of mucosal healing with improved prognosis. However, despite the increasing clinical realization of the significance of the concept of mucosal healing, its regulation and means of therapeutic targeting remain largely unclear. Here, stem-cell therapy, which uses hematopoietic stem cells or mesenchymal stem cells, remains a promising option. Stem cells are the pluripotent cells with ability to differentiate into the epithelial and/or immune-modulatory cells. The over-reaching concept is that the stem cells can migrate to the damaged areas of the intestine to provide curative help in the mucosal healing process. Moreover, by differentiating into the mature intestinal epithelial cells, the stem cells also help in restoring the barrier integrity of the intestinal lining and hence prevent the immunomodulatory induction, the root cause of the IBD. In this article, we elaborate upon the current status of the clinical management of IBD and potential role of the stem cell therapy in improving IBD therapy and patient’s quality of life.

Keywords: Crohn′s disease; Ulcerative colitis; Mesenchymal stem cells; Hematopoietic stem cells; Mucosal healing

Core Tip: Mucosal healing is gaining acceptance as a measure of the disease activity remission in inflammatory bowel disease (IBD) patients, however, its regulation and means of therapeutic targeting remain unclear. In this article, we elaborate upon stem-cell therapy, which uses hematopoietic or mesenchymal stem cells, as a promising therapeutic option for IBD. The over-reaching concept is that the stem cells can migrate to the damaged areas of the intestine and differentiate into the mature intestinal epithelial cells to restore the barrier integrity of the intestinal lining, and hence, prevent the immunomodulatory induction, the root cause of IBD, and thus patient’s quality of life.